This chapter offers guidelines for specimen collection and transport, specimen handling, specimen pretreatment and processing in the laboratory, medium selection, and incubation of cultures. Abscess specimens should be collected from the active peripheral edge of open abscesses or aspirated from closed abscesses by use of a syringe. Fungemia is a major cause of morbidity and mortality in hospitalized patients, with Candida species being the major cause. Early detection of organisms in the bloodstream is incredibly important because it is an indicator of disseminated disease. As in bacteriology, the volume of blood, the blood-to-broth ratio, and the number of blood cultures are all critical factors, with the volume of blood being the most important variable. Bone marrow is most useful for the diagnosis of disseminated candidiasis, cryptococcosis, and histoplasmosis. Subcutaneous tissue should be examined for the presence of granules. The chapter contains a table listing various media used for the recovery of fungi from clinical specimens, including primary media, selective and/or differential media, and specialized media. A wide variety of media are available for primary isolation, and in many laboratories, the choice is based on personal experience and the technologist's preferences. Mycology laboratories that are responsible for culturing Nocardia and aerobic actinomycetes must include other media for these pathogens, such as Sabouraud agar.

7.Chiarini, A.,, A.Palmeri,, T.Amato,, R.Immordino,, S.Distefano,, and A.Giammanco. 2008. Detection of bacterial and yeast species with the Bactec 9120 automated system with routine use of aerobic, anaerobic, and fungal media. J. Clin. Microbiol.46:4029–4033.

55.Watts, B.,, P.Argekar,, S.Saint,, and C. A.Kauffman. 2007. Clinical problem-solving. Building a diagnosis from the ground up—a 49-year-old man came to the clinic with a 1-week history of suprapubic pain and fever. N. Engl. J. Med.356:1456–1462.